Aesthetic Plastic Surgery最新文献

{"title":"Functional Stratification of Adipose-Derived Stem Cells via Gradient Density Centrifugation: D-ASCs Drive Vascularization for Enhanced Fat Graft Survival.","authors":"Jie Long, Guo Chen, Zijin Qin, Changxin Jin, Hengxin Liu, Jie Chen, Baoqiang Song, Ziang Zhang","doi":"10.1007/s00266-026-05870-8","DOIUrl":"https://doi.org/10.1007/s00266-026-05870-8","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the functional heterogeneity of adipose-derived stem cells (ASCs) in fat grafting and develop a density-based separation method to isolate distinct ASC subpopulations for improving graft survival.</p><p><strong>Methods: </strong>ASCs were isolated from human lipoaspirates and subjected to adipogenic differentiation. A novel Percoll density gradient centrifugation protocol (10-100%, 300 × g, 35 min) was developed to separate ASCs into upper-layer (U-ASCs) and lower-layer (D-ASCs) subpopulations. Their adipogenic and angiogenic potentials were assessed through Oil Red O staining and Matrigel tube formation assays. In vivo functionality was evaluated in nude mice (n = 84) receiving fat grafts supplemented with GFP-labeled U-ASCs, D-ASCs, or unsorted ASCs (n = 28/group), with graft retention, histology, and cellular fate analyzed over 12 weeks.</p><p><strong>Results: </strong>Density separation yielded two functionally distinct populations: U-ASCs exhibited 3.2-fold greater lipid accumulation (p < 0.001), while D-ASCs showed 2.7-fold enhanced tube formation (p < 0.01). In vivo, D-ASCs grafts demonstrated 58.3 ± 6.7% retention at 12 weeks versus 32.1 ± 5.2% for U-ASCs (p < 0.001), with significantly reduced oil cysts (p < 0.05) and 2.4-fold higher vascular density (p < 0.001). Immunofluorescence revealed U-ASCs primarily differentiated into adipocytes (GFP+/Perilipin+), whereas D-ASCs integrated into vasculature (GFP+/CD31+).</p><p><strong>Conclusion: </strong>ASC subpopulations differentially regulate fat graft outcomes-U-ASCs drive adipogenesis while D-ASCs enhance vascularization. The developed density separation method enables isolation of therapeutic ASC subsets, with D-ASCs showing superior potential for improving graft survival through neovascularization. These findings support precision strategies in cell-assisted lipotransfer.</p><p><strong>Level of evidence i: </strong>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revision Rhinoplasty in Retrocolumellar Perforation.","authors":"Sercan Göde, Aynur Aliyeva, Mehmet Burak Apaydın, Elad Azizli","doi":"10.1007/s00266-026-05849-5","DOIUrl":"https://doi.org/10.1007/s00266-026-05849-5","url":null,"abstract":"<p><strong>Background: </strong>Retrocolumellar perforations (RCPs) are rare complications of revision rhinoplasty, often associated with columellar retraction, shortened nasal length, and loss of tip projection. Their repair requires vascularized flaps that provide both mucosal coverage and structural support at the tip.</p><p><strong>Objective: </strong>To evaluate the surgical outcomes of RCP repair using endonasal and gingivobuccal flaps, with emphasis on perforation closure, nasal tip projection, and patient-reported outcomes.</p><p><strong>Methods: </strong>A cohort of 28 patients (mean age 35.6 years; 17 men, 11 women) underwent RCP repair. Most had ≥ 2 prior nasal surgeries (71.4%). Risk factors included smoking (64.3%) and cocaine use (35.7%). All patients had nasal skin contraction, short noses, and a retracted columella. Flap techniques were selected according to intraoperative anatomy, and rib cartilage grafts were used in all cases. Outcomes were assessed by perforation status, nasal tip projection, and the Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS).</p><p><strong>Results: </strong>Perforation closure was achieved in 27 of 28 patients (96.4%). Stable and desired nasal tip projection was maintained in 23 patients (82.1%), whereas 4 patients had drooping nasal tips despite RCP closure. SCHNOS scores improved significantly from 18.2 ± 8.5 preoperatively to 89.4 ± 10.7 postoperatively (p < 0.001, Cohen's d = 3.68). Among patients reconstructed with gingivobuccal flaps (n = 18), 16/18 (88.9%) maintained stable tip projection, suggesting a favorable trend but not demonstrating superiority.</p><p><strong>Conclusion: </strong>RCP repair using structured vascularized flaps achieves high closure rates, reliable nasal tip support, and significant functional and cosmetic improvement. Gingivobuccal flaps are particularly valuable in revision cases with compromised anterior support.</p><p><strong>Level of evidence iv: </strong>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Safety and Efficacy of Tranexamic Acid Use in Blepharoplasty: A Systematic Review of Randomized Controlled Trials.","authors":"Rawan ElAbd, Yasmina Richa, Lucy Pu, Taliah Hiyzajie, Sinan Jabori, Tyler Safran, Mirko Gilardino","doi":"10.1007/s00266-026-05850-y","DOIUrl":"https://doi.org/10.1007/s00266-026-05850-y","url":null,"abstract":"<p><strong>Introduction: </strong>TXA is garnering increasing attention for aesthetic periorbital procedures for its ability to reduce postoperative ecchymosis and bruising. The aim of this systematic review is to compile the current literature evidence on the effectiveness and safety of TXA in blepharoplasty.</p><p><strong>Methods: </strong>Following PRISMA guidelines, this systematic review identified articles from PubMed, MEDLINE, Cochrane, and EMBASE databases up to October 4th, 2024, aiming to assess the efficacy of TXA in reducing bleeding and edema in patients undergoing blepharoplasty.</p><p><strong>Results: </strong>Five studies were included, comprising a total of 604 patients who underwent blepharoplasty with TXA administration. TXA concentrations ranged from 50mg/mL to 100mg/mL locally, and 1g IV. Three studies reported a reduction in intra-operative bleeding with local TXA, with one study demonstrating statistical difference (p < 0.001). Statistically significant reduction in time to achieve hemostasis with IV TXA (p < 0.0001) and reductions in ecchymosis at 1 week postoperatively (p = 0.04) were reported. One study reported a statistically significant reduction in edema scores at 1 (p = 0.002) and 7 days (p = 0.01) postoperatively. Procedure times remained unchanged or reduced, with one study showing statistical significance with both IV (p = 0.003) and local (p = 0.03) TXA. None of the studies reported any infections or wound complications.</p><p><strong>Conclusion: </strong>TXA administration appears to reduce intra-operative bleeding and postoperative ecchymosis and edema after blepharoplasty with no significant complications reported with IV and local administrations of TXA in the included studies. The development of standardized protocols for TXA administration highlighting the optimal dosage, timing, and administration routes is recommended.</p><p><strong>Level of evidence i: </strong>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Seroma in Lipedema Surgery: A Retrospective Analysis of 93 Cases from a Single Surgical Team.","authors":"Fernando Campos Moraes Amato, Lorena Guimarães Lima Amato, Alexandre Campos Moraes Amato, Daniel Augusto Benitti","doi":"10.1007/s00266-026-05774-7","DOIUrl":"https://doi.org/10.1007/s00266-026-05774-7","url":null,"abstract":"<p><strong>Background: </strong>Lipedema is a chronic adipose tissue disorder characterized by abnormal and disproportionate fat accumulation in the extremities, leading to pain, edema, and functional impairment. Liposuction has become a central component of surgical management. However, postoperative complications, particularly seroma formation, remain a concern.</p><p><strong>Objectives: </strong>To evaluate the incidence of postoperative seroma and associated risk factors in patients undergoing liposuction for lipedema treatment, based on procedures performed by a single surgical team in a single institution.</p><p><strong>Methods: </strong>This retrospective observational study included 93 female patients who underwent liposuction for lipedema between April 2019 and January 2024. Data collected included demographic variables, body mass index (BMI), anesthesia type, volume of aspirated fat, percentage of body weight removed, use of adjunct technologies (ultrasound or laser), association with other surgeries such as varicose vein surgery, and prior conservative treatment. The primary outcome was the development of postoperative seroma. Statistical analysis included Chi-square and Student's t-tests and multivariable logistic regression, with significance set at p ≤ 0.05.</p><p><strong>Results: </strong>Among 93 cases, 17 patients (18.3%) developed postoperative seroma. Higher volumes of aspirated fat (% body weight) were significantly associated with seroma formation (7.27% vs. 5.84%, p = 0.005). Concomitant minor procedures were also linked to increased seroma incidence (p = 0.035). No seromas occurred in patients treated using ultrasound-assisted liposuction. Minor complications included one infection and one hematoma (1.07%).</p><p><strong>Conclusions: </strong>Liposuction for lipedema is a safe and effective surgical option with a low rate of major complications, but seroma remains a relatively frequent postoperative finding. Higher aspirated fat volumes relative to body weight and the presence of concomitant procedures increase the risk of seroma. No seromas were observed in the ultrasound-assisted group; however, this difference did not reach statistical significance and should be considered only as hypothesis-generating. Further studies are needed to validate these findings and guide surgical decision-making.</p><p><strong>Level of evidence iv: </strong>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined Ultrasound and Power-Assisted Liposuction Improves Outcomes in Lipedema: A Retrospective Study.","authors":"Agostino Bruno, Riccardo Foti","doi":"10.1007/s00266-026-05888-y","DOIUrl":"https://doi.org/10.1007/s00266-026-05888-y","url":null,"abstract":"<p><strong>Introduction: </strong>Lipedema is a chronic adipose tissue disorder characterized by disproportionate fat deposition, primarily in the lower extremities, leading to pain, functional impairment, and reduced quality of life. While Power-Assisted Liposuction (PAL) is the standard surgical approach, the integration of Ultrasound-Assisted Liposuction (UAL) with PAL has been proposed to enhance fat removal and improve patient outcomes.</p><p><strong>Objective: </strong>To compare the clinical efficacy, postoperative outcomes, and complication rates of PAL alone versus UAL + PAL in patients with Stage II and III lipedema.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on 60 female patients diagnosed with lipedema (Stage II and III). 30 patients underwent PAL alone, while 30 received UAL followed by PAL. Primary outcomes included the volume of fat aspirated, circumferential reduction, and postoperative pain, measured at multiple time points over a 12-month follow-up. Secondary outcomes assessed patient satisfaction, time to return to daily activities, and complication rates.</p><p><strong>Results: </strong>The UAL + PAL group demonstrated a significantly higher mean fat extraction volume (5,500 ± 450 mL) compared to the PAL group (4,100 ± 380 mL; p < 0.01). Circumferential reduction was greater in the UAL + PAL group, with an average reduction of 12.5 cm versus 8.2 cm in the PAL group (p < 0.01). Postoperative pain, assessed using a Visual Analog Scale (VAS), was significantly lower in the UAL + PAL group (VAS 4.5 ± 0.7) compared to the PAL group (VAS 6.2 ± 0.8 at 24 hours post-surgery; p < 0.01). Additionally, patients treated with UAL + PAL reported a faster return to daily activities (9.3 ± 1.8 days vs. 12.8 ± 2.1 days; p < 0.01) and higher satisfaction scores (4.8 ± 0.5 vs. 4.2 ± 0.6 on a 5-point Likert scale; p < 0.05). Complication rates were comparable between the two groups, with no major adverse events reported.</p><p><strong>Conclusion: </strong>UAL + PAL offers significant advantages over PAL alone in the surgical management of lipedema, providing superior fat removal, reduced postoperative pain, faster recovery, and improved patient satisfaction. These findings support the integration of UAL into standard liposuction protocols for advanced-stage lipedema, emphasizing its efficacy in overcoming the challenges posed by fibrotic adipose tissue.</p><p><strong>Level of evidence iv: </strong>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of Tranexamic Acid in Liposuction for Lipedema: A Retrospective Study on 230 Procedures.","authors":"Agostino Bruno, Riccardo Foti","doi":"10.1007/s00266-026-05874-4","DOIUrl":"https://doi.org/10.1007/s00266-026-05874-4","url":null,"abstract":"<p><strong>Background: </strong>Lipedema is a chronic, progressive disorder of subcutaneous adipose tissue that mainly affects women. It is characterized by disproportionate fat hypertrophy, pain, bruising, and marked resistance to diet and exercise. Tumescent liposuction remains the only effective treatment to slow or reverse disease progression, but involves large volumes and fragile microvasculature, increasing bleeding risk.</p><p><strong>Objective: </strong>This study aimed to evaluate whether perioperative tranexamic acid (TXA) reduces intraoperative blood loss, postoperative bruising, and early complications in lipedema liposuction.</p><p><strong>Methods: </strong>We retrospectively analyzed 230 staged liposuction procedures for lipedema performed between 2021 and 2024 at a single center. Patients received TXA intravenously, locally, or in combination, or no TXA. Primary outcomes were estimated intraoperative blood loss and postoperative ecchymosis. Secondary endpoints included hematoma, transfusion need, thromboembolic events, infections, and recovery time.</p><p><strong>Results: </strong>All TXA groups showed significantly lower intraoperative blood loss and hemoglobin drop versus controls (p < 0.01). Local and combined routes were most effective, with the combined approach yielding the lowest ecchymosis scores. Hematoma rates dropped from 12% (no TXA) to 0-6.7% (TXA), and no thromboembolic or infectious complications were observed. No TXA-treated patients required transfusions, while 6% of controls did.</p><p><strong>Conclusions: </strong>TXA use in lipedema liposuction significantly reduces bleeding and bruising without increasing thromboembolic risk. Combined systemic and local administration appears most beneficial. These findings support TXA as a safe, effective adjunct in multistage, high-volume liposuction for lipedema. Prospective trials are needed to confirm the optimal protocol in this unique population.</p><p><strong>Level of evidence iii: </strong>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147809703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Management of Dorsocervical Fibro-Lipodystrophy (Buffalo Hump): Systematic Review and Meta-Analysis.","authors":"Joseph M Escandón, Chihiro Matsui, Gabriel De La Cruz Ku, Lauren Escandón, Pedro Ciudad, Oscar J Manrique","doi":"10.1007/s00266-026-05880-6","DOIUrl":"https://doi.org/10.1007/s00266-026-05880-6","url":null,"abstract":"<p><strong>Background: </strong>Dorsocervical fibro-lipodystrophy, commonly known as \"buffalo hump,\" presents a challenging deformity often associated with HIV-related lipodystrophy or idiopathic etiologies. Although various surgical techniques have been reported, a comprehensive evaluation of their safety, efficacy, and recurrence rates remains lacking. This systematic review and meta-analysis aimed to evaluate outcomes of surgical interventions, particularly suction-assisted lipectomy, in managing dorsocervical fibro-lipodystrophy.</p><p><strong>Methods: </strong>A systematic review with meta-analysis was conducted using PubMed and ScienceDirect. Eligible studies reported surgical outcomes of dorsocervical fibro-lipodystrophy managed with suction-assisted or excisional lipectomy. Meta-analyses used a random-effects model, with heterogeneity and publication bias assessed. Sensitivity analysis was performed.</p><p><strong>Results: </strong>Twenty-two studies encompassing 218 patients were included. Most cases were associated with HIV-related lipodystrophy, and the average patient age was 47.4 years. Suction-assisted lipectomy was the most common approach. The pooled recurrence rate with liposuction was 10.6%, and revision procedures occurred in 15.3% of cases. Following sensitivity analysis, recurrence and revision rates decreased to 1.4% and 1.3%, respectively, with minimal heterogeneity. The pooled recurrence rate after excisional lipectomy and hybrid techniques was 0%. Reported complications included seroma, hematoma, wound dehiscence, and bacteremia, with higher rates observed in excisional or hybrid approaches. Methodological quality varied, with most studies scoring moderately.</p><p><strong>Conclusion: </strong>Suction-assisted lipectomy appears to be a safe and effective treatment for dorsocervical fibro-lipodystrophy, especially when performed with meticulous technique. However, the overall low quality of evidence underscores the need for prospective studies to optimize management strategies.</p><p><strong>Level of evidence iii: </strong>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147809626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of PECS I Block and Local Anesthetic Infiltration for Pain Management in Breast Augmentation: A Prospective, Split-Body Study.","authors":"Mert Ersan, Ozge Koner","doi":"10.1007/s00266-026-05885-1","DOIUrl":"https://doi.org/10.1007/s00266-026-05885-1","url":null,"abstract":"<p><strong>Background: </strong>While various analgesic methods have been proposed in breast augmentation, limited data exist comparing their efficacy in a controlled setting. This prospective, split-body study aimed to compare the effectiveness of preoperative PECS I block and intraoperative direct local anesthetic infiltration for postoperative pain control following breast augmentation.</p><p><strong>Methods: </strong>Twenty female patients (ASA I-II, aged 18-59) undergoing bilateral breast augmentation with identical implants via dual-plane or submuscular approaches were included. Each patient received a PECS I block on the right breast (10 mL of 0.5% bupivacaine) performed preoperatively by the same anesthesiologist. The left breast received an identical dose via direct local anesthetic infiltration administered by the same plastic surgeon prior to muscle transection. Postoperative pain was evaluated using the Numeric Rating Scale (NRS) at 30 min intervals for the first 2 h, every 2 h between 2 and 6 h, at 24 h, on postoperative day 5, and at 3 months.</p><p><strong>Results: </strong>Pain scores were significantly lower on the PECS I block side compared to the local infiltration side during the early postoperative period (30 min to 6 h) (p < 0.05). No significant difference was observed at 24 h, day 5, or 3 months. The mean tramadol requirement in the first 6 h was 72.0 ± 10.05 mg, with a total of 171.0 ± 21.98 mg at 24 h.</p><p><strong>Conclusions: </strong>In this split-body study, PECS I block provided superior pain control during the early postoperative period (first 6 h) compared to direct local infiltration.</p><p><strong>Level of evidence ii: </strong>Evidence Based Medicine Level: Evidence Level II, Therapeutic Study. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147809711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histological and Biomechanical Comparison of Different Dissection Planes in Brow Lift: An Experimental Rabbit Model and Its Clinical Implications.","authors":"Serhat Şibar, Muzaffer Duran, Sami Can Yeşilırmak, Elifnaz Perdeci, Fatma Kübra Erbay Elibol, Süheyla Esra Özkoçer, Bilge Kaan İsmail","doi":"10.1007/s00266-026-05873-5","DOIUrl":"https://doi.org/10.1007/s00266-026-05873-5","url":null,"abstract":"<p><strong>Background: </strong>Different dissection planes used in brow lift surgery-namely, subcutaneous, subgaleal, and subperiosteal-present distinct biomechanical and histological characteristics. This study aimed to compare these three dissection approaches in terms of tissue healing and mechanical resistance.</p><p><strong>Methods: </strong>In this experimental model using New Zealand white rabbits, three groups of eight animals each underwent subcutaneous, subgaleal, or subperiosteal dissection. After a 12-week healing period, tissue samples were harvested for either histological or biomechanical analysis. Epidermal, dermal, superficial musculoaponeurotic system (SMAS), and periosteal thicknesses were quantitatively measured using ImageJ software. Biomechanical parameters assessed included maximum load, stiffness, and yield load.</p><p><strong>Results: </strong>Histological evaluation revealed preserved tissue integrity in all groups, with no evidence of fibrosis or disrupted collagen organization. A statistically significant difference in the epidermis/dermis ratio was observed between the control group and both the subgaleal and subperiosteal groups (p < 0.05). In biomechanical testing, the subperiosteal group demonstrated significantly superior values for maximum load, stiffness, and yield load compared to the other groups (p < 0.05).</p><p><strong>Conclusion: </strong>These findings suggest that while the subperiosteal plane offers greater long-term mechanical stability, the subcutaneous approach may support a more physiological healing pattern. This is supported by its closer resemblance to the control group in epidermis-to-dermis ratios and the absence of fibrotic remodeling. The preservation of native tissue architecture in this group highlights its potential as a biologically favorable plane in selected patients. Dissection plane selection should be individualized based on the patient's specific tissue characteristics and surgical goals.</p><p><strong>No level assigned: </strong>This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes review articles, book reviews, and manuscripts that concern basic science, animal studies, cadaver studies, and experimental studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-Stage Reconstruction with a Bilayer Artificial Dermal Regeneration Matrix for Nasal Skin Malignancies Defects in Middle-Aged and Elderly Asian Patients: Minimizing Scarring and Morbidity.","authors":"Huafeng Sun, Weilin Cai, Pingping Xu","doi":"10.1007/s00266-026-05801-7","DOIUrl":"https://doi.org/10.1007/s00266-026-05801-7","url":null,"abstract":"<p><strong>Background: </strong>Nasal reconstruction in Asian patients is challenging given thicker skin, abundant sebaceous glands, and Fitzpatrick skin types III-V, which increase the risk of hypertrophic scarring and pigmentary alterations. Traditional flaps and grafts frequently result in donor-site morbidity, contour deformities, and color mismatch. Conversely, bilayer artificial dermal substitutes offer a potential alternative.</p><p><strong>Methods: </strong>This retrospective study included eighteen middle-aged and elderly Chinese patients with nasal skin malignancies (0.5 × 0.5 to 2.3 × 2.6 cm) who underwent standard surgical excision followed by single-stage nasal reconstruction using a bilayer artificial dermis (Lando®). In all cases, intraoperative frozen-section analysis was routinely performed to confirm negative peripheral and deep margins prior to reconstruction. Postoperative management involved routine dressing changes until re-epithelialization. Follow-up was conducted for up to 2 years.</p><p><strong>Results: </strong>All defects healed within a mean of 32.67 ± 6.58 days, without requiring secondary grafting or encountering major complications. Minor complications included one superficial infection managed with increased frequency of local wound dressing changes (Clavien-Dindo grade I) and one case of mild hypertrophic scarring that required no additional intervention (Clavien-Dindo grade I). All patients achieved satisfactory wound healing with acceptable nasal contour, and no tumor recurrence was observed during follow-up.</p><p><strong>Conclusion: </strong>Single-stage reconstruction using a bilayer artificial dermal substitute is a simple, safe, and effective option for nasal defect repair in Asian patients. It avoids donor-site harvesting, simplifies postoperative management, and may help reduce overall treatment burden, offering a valuable alternative to traditional reconstructive techniques.</p><p><strong>Level of evidence iv: </strong>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}